中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
11期
1010-1013
,共4页
穆春苓%赵翠萍%侯洁宁%姜丽丝%崔同强%白冰
穆春苓%趙翠萍%侯潔寧%薑麗絲%崔同彊%白冰
목춘령%조취평%후길저%강려사%최동강%백빙
高血压%择时服约%治疗结果
高血壓%擇時服約%治療結果
고혈압%택시복약%치료결과
Hypertension%Select time take medicine%Treatment outcome
目的 探讨不同服药方法 对于高血压治疗有效性和平稳性的影响.方法 采用随机、单盲、平行对照设计,对90例2级及以上原发性高血压患者,随机分为早晨服用非洛地平和缬沙坦组(A组30例,男15例,女15例),早晨服用缬沙坦晚上服非济地平组(B组30例,男17例,女13例),早晨服用非洛地平晚上服缬沙坦组(C组30例,男16例,女14例),患者均于服药前及服药后2周进行动态血压监测求得平滑指数等指标.结果 服药2周后,各组夜间时段及24 h的平均收缩压的下降值依此为:19.3、28.8、30.5、22.9、28.3及29.1 mm Hg(1 mm Hg=0.133 kPa).组间比较,A组<B组(P<0.01),A组<C组(P<0.01),各组夜间时段及24 h的平均动脉压的下降值依次为:16.8、19.1、20.7、17.1、19.2及19.9 mm Hg.绀间比较,A组<B组(P<0.05),A组<C组(P<0.01),以上各值A组与B组、A组与C组均有统计学意义,而B组与C组间数值上虽有差异,却无统计学意义(P>0.05).夜间及24 h平均收缩压平滑指数符组依次为:2.43,3.12,3.22及1.92,2.49,2.27,组间比较,夜间平均收缩压平滑指数A组<B组(P<0.01),A组<C组(P<0.01);24 h平均收缩压平滑指数A组<C组(P<0.01),A组<B组(P<0.01);夜间及24 h平均动脉压平滑指数依次为:4.20、4.74、4.91、2.69、3.08及3.26.组间比较A组<B组(P<0.05),A组<C组(P<0.01);夜间舒张压平滑指数分别为:2.52、3.66、3.12,组间比较A组<B组(P<0.01),A组<C组(P<0.05),以上各值A组与B组、A组与C组均有统计学意义,而以上各项平滑指数比较B组与C组间差异无统计学意义(P>0.05).结论 联合用药的降压效果显著,早晚分次服药较早晨顿服两种药物能更有效控制夜间血压,早晚分次服药使夜间及24 h血压下降更平稳.
目的 探討不同服藥方法 對于高血壓治療有效性和平穩性的影響.方法 採用隨機、單盲、平行對照設計,對90例2級及以上原髮性高血壓患者,隨機分為早晨服用非洛地平和纈沙坦組(A組30例,男15例,女15例),早晨服用纈沙坦晚上服非濟地平組(B組30例,男17例,女13例),早晨服用非洛地平晚上服纈沙坦組(C組30例,男16例,女14例),患者均于服藥前及服藥後2週進行動態血壓鑑測求得平滑指數等指標.結果 服藥2週後,各組夜間時段及24 h的平均收縮壓的下降值依此為:19.3、28.8、30.5、22.9、28.3及29.1 mm Hg(1 mm Hg=0.133 kPa).組間比較,A組<B組(P<0.01),A組<C組(P<0.01),各組夜間時段及24 h的平均動脈壓的下降值依次為:16.8、19.1、20.7、17.1、19.2及19.9 mm Hg.紺間比較,A組<B組(P<0.05),A組<C組(P<0.01),以上各值A組與B組、A組與C組均有統計學意義,而B組與C組間數值上雖有差異,卻無統計學意義(P>0.05).夜間及24 h平均收縮壓平滑指數符組依次為:2.43,3.12,3.22及1.92,2.49,2.27,組間比較,夜間平均收縮壓平滑指數A組<B組(P<0.01),A組<C組(P<0.01);24 h平均收縮壓平滑指數A組<C組(P<0.01),A組<B組(P<0.01);夜間及24 h平均動脈壓平滑指數依次為:4.20、4.74、4.91、2.69、3.08及3.26.組間比較A組<B組(P<0.05),A組<C組(P<0.01);夜間舒張壓平滑指數分彆為:2.52、3.66、3.12,組間比較A組<B組(P<0.01),A組<C組(P<0.05),以上各值A組與B組、A組與C組均有統計學意義,而以上各項平滑指數比較B組與C組間差異無統計學意義(P>0.05).結論 聯閤用藥的降壓效果顯著,早晚分次服藥較早晨頓服兩種藥物能更有效控製夜間血壓,早晚分次服藥使夜間及24 h血壓下降更平穩.
목적 탐토불동복약방법 대우고혈압치료유효성화평은성적영향.방법 채용수궤、단맹、평행대조설계,대90례2급급이상원발성고혈압환자,수궤분위조신복용비락지평화힐사탄조(A조30례,남15례,녀15례),조신복용힐사탄만상복비제지평조(B조30례,남17례,녀13례),조신복용비락지평만상복힐사탄조(C조30례,남16례,녀14례),환자균우복약전급복약후2주진행동태혈압감측구득평활지수등지표.결과 복약2주후,각조야간시단급24 h적평균수축압적하강치의차위:19.3、28.8、30.5、22.9、28.3급29.1 mm Hg(1 mm Hg=0.133 kPa).조간비교,A조<B조(P<0.01),A조<C조(P<0.01),각조야간시단급24 h적평균동맥압적하강치의차위:16.8、19.1、20.7、17.1、19.2급19.9 mm Hg.감간비교,A조<B조(P<0.05),A조<C조(P<0.01),이상각치A조여B조、A조여C조균유통계학의의,이B조여C조간수치상수유차이,각무통계학의의(P>0.05).야간급24 h평균수축압평활지수부조의차위:2.43,3.12,3.22급1.92,2.49,2.27,조간비교,야간평균수축압평활지수A조<B조(P<0.01),A조<C조(P<0.01);24 h평균수축압평활지수A조<C조(P<0.01),A조<B조(P<0.01);야간급24 h평균동맥압평활지수의차위:4.20、4.74、4.91、2.69、3.08급3.26.조간비교A조<B조(P<0.05),A조<C조(P<0.01);야간서장압평활지수분별위:2.52、3.66、3.12,조간비교A조<B조(P<0.01),A조<C조(P<0.05),이상각치A조여B조、A조여C조균유통계학의의,이이상각항평활지수비교B조여C조간차이무통계학의의(P>0.05).결론 연합용약적강압효과현저,조만분차복약교조신돈복량충약물능경유효공제야간혈압,조만분차복약사야간급24 h혈압하강경평은.
Objective To investigate the impact of antihypertensive medication timing on degree and stability of blood pressure (BP) lowering in patients with moderate and severe essential hypertension. Methods Ninety patients were randomly assigned to take Valsartan and Felodiping together in the morning (group A), Valsartan in the morning and Felodiping in the evening (group B) or Felodiping in the morning and Valsartan in the evening (group C, n=30 each). The morning dosage was titrated if the goal blood pressure was not achieved. Ambulatory blood pressure monitoring (ABPM) was performed on the first and 14~(th) day of medication. Results The BP reductions during nighttime and twenty-four in group B and C hours were similar (P>0.05) but were significant more than those in group A (P<0.05). The smoothness indexes of mean systolic, mean arterial blood pressure during nighttime and twenty-four in group B and C were similar but significantly higher than that in group A (P<0.05). The smoothness index of diastolic pressure at nighttime in group B and C was similar but signifieantly higher than that in group A (P<0.05). Conclusion More significant and stable antihypertensive effects could be achieved by taking the two antihypertensive medications separately in the morning and at evening compared that taken the two drugs together in the morning.
